Gd-EOB-DTPA增强MR胆管成像对乙肝肝硬化患者的诊断价值

Diagnostic value of Gd-EOB-DTPA-enhanced MR cholangiography in patients with hepatitis B cirrhosis

目的探讨钆塞酸二钠(Gd-EOB-DTPA)增强MR胆管成像(EOB-MRC)对乙肝肝硬化患者的诊断价值。方法回顾性分析2020年1月至2021年3月深圳市第三人民医院收治的80例乙肝肝硬化患者(观察组)的临床资料,并选择同时期来院就诊的80例非肝硬化患者作为对照组。两组患者均行Gd-EOB-DTPA增强MR胆管成像,比较两组患者的肝功能指标[血浆凝血酶原时间(PT)、总胆红素(TB)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血小板、γ-谷氨酰基转移酶(GGT)及碱性磷酸酶(ALP)]及胆管树显示程度。结果观察组患者的PT、TB、GGT及ALP水平分别为(16.27±2.88)s、(29.05±9.17)μmol/L、(150.25±49.44)U/L和(145.64±48.05)U/L,明显高于对照组的(14.13±2.75)s、(12.54±4.13)μmol/L、(32.25±10.06)U/L和(104.78±28.33)U/L,差异均有统计学意义(P<0.05),而两组患者的AST、ALT、AST/ALT及血小板水平比较差异均无统计学意义(P>0.05);Gd-EOB-DTPA注射5 min、10 min、15 min及20 min时,两组患者的胆管树显示程度差异均有统计学意义(P<0.05)。结论相较于非肝硬化患者的清晰胆管树显示,乙肝肝硬化患者的胆管树显示不清晰或者不显示,Gd-EOB-DTPA增强MR胆管成像可以作为乙肝肝硬化患者肝功能的一种判断方法。

Objective To explore the diagnostic value of gadoxetic acid disodium(Gd-EOB-DTPA)-enhanced MR cholangiography in patients with hepatitis B cirrhosis.Methods The clinical data of 80 patients with hepatitis B cirrhosis(observation group)admitted to Shenzhen Third People’s Hospital from January 2020 to March 2021 were retrospectively analyzed,and 80 patients without cirrhosis who visited the hospital at the same time were selected as the control group.The two groups of patients all underwent Gd-EOB-DTPA-enhanced MR cholangiography.Liver function indexes[plasma prothrombin time(PT),total bilirubin(TB),aspartate aminotransferase(AST),alanine aminotransferase(ALT),platelets,γ-glutamyl transfer enzyme(GGT),and alkaline phosphatase(ALP)]and the display degree of bile duct tree were compared between the two groups.Results The levels of PT,TB,GGT,and ALP in the observation group were(16.27±2.88)s,(29.05±9.17)μmol/L,(150.25±49.44)U/L,and(145.64±48.05)U/L,which were significantly higher than(14.13±2.75)s,(12.54±4.13)μmol/L,(32.25±10.06)U/L,and(104.78±28.33)U/L in the control group(P<0.05);but there was no significant difference in AST,ALT,AST/ALT,and platelet levels between the two groups(P>0.05).When Gd-EOB-DTPA was injected for 5 min,10 min,15 min,and 20 min,the display degree of bile duct tree in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Compared with the clear bile duct tree in patients without cirrhosis,the bile duct tree of patients with hepatitis B cirrhosis is unclear or not displayed.Gd-EOB-DTPA-enhanced MR cholangiography can be used as a method to judge the liver function of patients with hepatitis B cirrhosis.